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1. Objektif 8. CPR (seorang

2. Pengenalan CPR penyelamat)
3. Sejarah CPR i. Protokol CPR
4. Anatomi Jantung ii. Jadual CPR
mengikut kategori
5. Peringkat Kematian mangsa
6. Konsep kitar mandiri 9. Komplikasi CPR
(chain of survival)
10.Kegagalan CPR
7. Definisi CPR
11.Rumusan
12.Penggunaan AED 2
Pada akhir sesi, peserta akan dapat:-

 Menyenaraikan peringkat-peringkat kematian.

 Menyenaraikan langkah asas CPR
 Melakukan rawatan CPR dan penggunaan AED
dengan betul berdasarkan teknik yang terkini

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1740 The Paris Academy of Sciences officially recommended mouth-
to-mouth resuscitation for drowning victims.
1767 The Society for the Recovery of Drowned Persons became the
first organized effort to deal with sudden and unexpected death.
1891 Dr. Friedrich Maass performed the first equivocally documented
chest compression in humans.
1903 Dr. George Crile reported the first successful use of external chest
compressions in human resuscitation.
1904 The first American case of closed-chest cardiac massage was
performed by Dr. George Crile.

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1954 James Elam was the first to prove that expired air was sufficient to maintain
adequate oxygenation.

1956 Peter Safar and James Elam invented mouth-to-mouth resuscitation.

1957 The United States military adopted the mouth-to-mouth resuscitation method to
revive unresponsive victims.

1960 Cardiopulmonary resuscitation (CPR) was developed. The American Heart

Association started a program to acquaint physicians with close-chest cardiac
resuscitation and became the forerunner of CPR training for the general public.

1963 Cardiologist Leonard Scherlis started the American Heart Association's CPR
Committee, and the same year, the American Heart Association formally endorsed
CPR.

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1966 The National Research Council of the National Academy of
Sciences convened an ad hoc conference on cardiopulmonary
resuscitation. The conference was the direct result of requests from the
American National Red Cross and other agencies to establish
standardized training and performance standards for CPR.
1972 Leonard Cobb held the world's first mass citizen training in CPR in
Seattle, Washington called Medic 2. He helped train over 100,000
people the first two years of the programs.
1973 Second National Conference on CPR and ECC.
1979 Advanced Cardiovascular Life Support (ACLS) is developed after
discussions held at the Third National Conference on CPR.

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1981 A program to provide telephone instructions in CPR began in King County,
Washington. The program used emergency dispatchers to give instant
directions while the fire department and EMT personnel were en route to
the scene. Dispatcher-assisted CPR is now standard care for dispatcher
centers throughout the United States.

1983 AHA convened a national conference on pediatric resuscitation to

develop CPR and ECC Guidelines for pediatric and neonatal patients.

1985 Fourth National Conference on CPR and ECC.

1988 AHA introduces first pediatric courses, pediatric BLS, pediatric ALS and
neonatal resuscitation, cosponsored with The American Academy of
Pediatrics (AAP).

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1990s Early Public Access Defibrillation (PAD) programs are developed with the
goal in mind to provide training and resources to the public so they are able
to aid in the successful resuscitation of sudden cardiac arrest victims

Feb
1992 Fifth National Conference on CPR and ECC.

1992 International Committee on Resuscitation (ILCOR) founded

1999 First task force on first aid was appointed First International
Conference on Guidelines for CPR and ECC

2004 AHA and ILCOR releases a statement regarding the use of AEDs on
children. It is determined that an AED may be used for children 1 to 8
years of age who have no signs of circulation.

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2005 AHA developed the Family & Friends® CPR Anytime® kit, a revolutionary product that
allows anyone to learn the core skills of CPR in just 20 minutes. The kit contains
everything needed to learn basic CPR, AED skills and choking relief anywhere, from
the comfort of your home to a large group setting

2005 The 2005 International Consensus on ECC and CPR Science with Treatment
Recommendations (CoSTR) Conference produces the 2005 American Heart
Association Guidelines for CPR & ECC. These Guidelines reveal a new
compression:ventilation ratio as well as changes to AED usage.

2008 The AHA releases a statement about Hands-Only™ CPR, saying that bystanders who
witness the sudden collapse of an adult should dial 911 and provide high-quality chest
compressions by pushing hard and fast in the middle of the victim’s chest.

2010 The 2010 International Consensus on ECC and CPR Science with Treatment
Recommendations (CoSTR) Conference produces the 2010 American Heart
Association Guidelines for CPR & ECC; 50th Anniversary of CPR

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organ yang berotot pejal
Mempunyai empat ruang
menyamai saiz penumbuk individu berkenaan.
Terletak dalam bahagian dada, diantara dua paru-
paru, dan dibawah tulang rusuk kiri.

Fungsi utama jantung adalah untuk mengepam darah

yang beroksigen ke seluruh bahagian tubuh. Tugas ini
dilakukan dengan menguncup sebanyak 60 hingga 90
kali bagi setiap minit. dengan setiap penguncupan
ruang jantung akan mengepam darah samada ke
venrikel atau salur darah arteri. dalam masa 24 jam
jantung anda berdenyut lebih daripada 100,000 kali,
7,000 liter darah dipam melalui jarak beribu batu di
dalam sistem saluran darah.

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 CLINICAL DEATH (KEMATIAN KLINIKAL)
Terhenti pernafasan dan denyutan jantung seketika.
( Dalam masa 0-4 minit, harapan pulih 25-30%)
BIOLOGICAL DEATH (KEMATIAN BIOLOGI)
Kematian sebenar berikut kekurangan oksigen ke otak dan
sel-sel otak mati dan mangsa akan mengalami proses
kematian sebenarnya.
( Selepas 4 minit, harapan pulih 5-10%)

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MINIT

0 * JANTUNG & PARU-PARU GAGAL BERFUNGSI

1 * SEL-SEL OTAK MENGGUNAKAN SAKI-BAKI OKSIGEN YANG ADA

4 * KEMATIAN KLINIKAL / TIADA LAGI SAKI-BAGI OKSIGEN

5 * SEL-SEL OTAK MULAI MATI

8 (BERIKAN BANTUAN AED DALAM MASA 10 MINIT)

10 * SEMUA SEL-SEL OTAK TELAH MATI

11 * KEMATIAN BIOLOGIKAL
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1. Prevention 3. Early 5. Post Cardiac
of arrest Defibrillation Care

2. Early 4. Early
CPR ACLS

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Satu tindakan bantuan awalan bagi
memulihkan mangsa yang terhenti
pernafasan dengan menggunakan
teknik tekanan di atas dada
(tekanan dari luar)
dan bantuan hembusan pernafasan

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 Penilaian dan keselamatan

Penyelamat pertama yang tiba di

tempat kejadian perlulah
memastikan dengan segera
bahawa diri, tempat kejadian dan
mangsa bebas dari bahaya.

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 Penilaian Tahap Kesedaran Mangsa

Tepuk bahu mangsa dan soal mangsa,

cth:- “Sir, are you all right”.
Jika mangsa tidak memberi sebarang
tindak balas, aktifkan EMS dan minta
AED.

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 Membuka saluran pernafasan
- Head Tilt Chin Lift
- Jaw Thrust (spinal injury)

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Perhatikan dada mangsa untuk
memeriksa samada mangsa
bernafas atau tidak dengan teknik
3M

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 Memberi tekanan ke atas dada

Sekiranya mangsa tidak bernafas,

lakukan tekanan di bahagian tengah
dada mangsa sebanyak 30 kali dengan
ke dalaman tekanan mengikut kategori
mangsa dan di ikuti dengan 2
hembusan (30 tekanan 2 hembusan).

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CENTER
OF
CHEST

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 30 TEKANAN : 2 HEMBUSAN
(1 KITARAN)
LENGKAPKAN 5 KITARAN
5 KITARAN = 1 PUSINGAN LENGKAP
PERIKSA NADI MANGSA SELEPAS 1
PUSINGAN LENGKAP
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 Pasangkan alat AED dan
berikan kejutan sekiranya
perlu

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1) Baringkan mangsa
dengan selesa jika perlu.
Jika tiada
2) Lindungi mangsa ditempat kecederaan &
yang selamat dan teduh. mangsa
3) Selimutkan mangsa untuk bernafas
kekalkan suhu atau haba dengan baik
panas badan. 25
 DEWASA KANAK- BAYI
KANAK

1 RATIO 30T : 2H 30T : 2H 30T : 2H

KITARAN 5 kitaran 5 kitaran 5 kitaran

1 Pusingan 1 Pusingan 1 Pusingan
TEKANAN & 150T : 10H 150T : 10H 150T : 10H
HEMBUSAN

KEDALAMAN 2 inci 2 inci 1.5 inci

KAEDAH 2 tangan 1 tangan 2 jari

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Unresponsive
No breathing or no normal
breathing

Activate Get
Emergency difibrillator
response

Start CPR
SH

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• Kemungkinan akan berlaku kecederaan pada tulang
rusuk (berlaku kepatahan)

• Kecederaan serius akan berlaku pada bahagian

dalaman terutamanya pada kawasan dada (paru-
paru, limpa) sekiranya tulang rusuk patah
(pendarahan akibat tikaman tulang yang patah)

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• Saluran pernafasan tidak dibuka dengan sempurna
(dongakkan kepala yang tidak betul)

• Hidung tidak dipicit semasa hembusan dilakukan

• Mangsa tidak dibaringkan ditempat yang stabil dan keras

• Kedudukan tangan penyelamat tidak tepat semasa

tekanan dilakukan

• Kadar tekanan ke atas dada terlalu cepat atau terlalu

lambat
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• Bantuan tiba

• Mangsa menunjukkan tanda hidup

• Telah terlalu lama melakukan CPR

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• Mangsa yang tiada kebenaran dari waris

• Pemegang rantai/gelang D.N.A.R

• Mangsa yang teputus/terkeluar organ penting

• Mati terlalu lama

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 Alat Automated External Diffibrillation (AED)
adalah merupakan satu alat elekronik
automatik mudah alih yang menganalisa
rentak jangtung mangsa/pesakit.

 Satu prosedur pemberian kejutan elektrik

yang terkawal untuk mengembalikan rentak
jantung normal dalam kes-kes cardiac
arrhythmias seperti Ventricular fibrillation (
VF ) & Ventricular tachycardia ( VT ).
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 Menyelamatkan nyawa pesakit yang
mengalami Ventricular fibrillation( VF ) &
Ventricular tachycardia ( VT ).

 Untuk mengenalpasti rentak jantung.

 Untuk merekod rentak sebelum dan

selepas defibrilasi jantung.

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Electrocardiogram (ECG)

Sinus rhythm
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 Recording of electrical potential generated by
the excitation of cardiac of theCOmuscle
: 4-8L/min
SA node SV : 50-100ml/beat
Sino-atrial Weight: approx. 300g
node (SA) Amount of blood : 4.7-5.5L

AV node

Bundle of His
Atrioventricular
node (AV)
Right and left
Purkinje fiber
bundle branch Bundle of His

Left bundle
Purkinje Fiber Right bundle branch
branch 36
37
 PURPOSE
To detect abnormalities of the heart
- Abnormal heart rate (too fast/too slow)
- arrhythmia (irregular beat)
- myocardial ischemia/infarction
ST change
ST elevation
Sinus Tachycardia (HR >100bpm)

Normal
Sinus Bradycardia (HR<60bpm)
ST depression

Atrial fibrillation 38
 Placement of electrodes
3 leads ECG 5 leads ECG

• Easy to monitor • V₅ lead allows

• Easy to perform CPR detection of coronary
and defibrillation artery ischemia
Able to view lead I, II, III Able to view lead I, II, III,
AvR, AvL, AvF, V₅
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How it works?
Electrodes attached to the chest
detect the action potential generated
by excitation of cardiac muscle

The potential is amplified

and displayed on the
monitor 40
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 KRETERIA MANGSA
1. Tidak sedarkan diri
2. Umur melebihi satu tahun
3. Tiada nadi
4. Tiada pernafasan
5. Saluran pernafasan tidak tersekat

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 TATACARA PENGGUNAAN
AED
1. Periksa tindak balas dan pernafasan mangsa
2. Periksa nadi
3. Letakkan AED berhampiran mangsa dan penyelamat yang akan
menggunakannya.
4. Tekan butang “Power On”
5. Letakkan Pad AED di bahagian atas dada.
6. Analisa rentak jantung
7. Berikan kejutan elektrik
8. Sekiranya tidak perlu, lakukan CPR
9. 5 pusingan atau 2 minit selepas AED akan ulang langkah 6 dan
7

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 Memberi bantuan CPR dengan secepat mungkin dapat memberi
peluang untuk mangsa terus hidup.

Tekanan sekurang-kurangnya 100 – 120/minit

Membenarkan penganjalan sempurna setiap tekanan
Kedalaman tekanan berdasarkan kategori mangsa
Meminimakan gangguan
Hembusan yang tidak berlebihan
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 KESIMPULAN
Alat AED ini mampu membantu kita
menyelamat mangsa kerana ianya senang
dikendalikan dan reka ciptaannya yang mudah
untuk digunakan oleh orang ramai dan
penyelamat.

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